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Prediction of microvascular invasion of hepatocellular carcinoma : usefulness of peritumoral hypointensity seen on gadoxetate disodium-enhanced hepatobiliary phase images

Other Titles
 간암의 미세혈관침범 예측: Gadoxetate disodium 조영 증강 후 얻은 자기공명영상상 지연기 종양 주변부 저음영의 유용성 
 Dept. of Radiology (영상의학교실) 
Issue Date
Dept. of Medicine/박사
PURPOSE: To determine whether peritumoral hypointensity seen on hepatobiliary phase images of preoperative gadoxetate disodium-enhanced magnetic resonance imaging (EOB-MRI) is useful for predicting microvascular invasion of hepatocellular carcinoma (HCC).METHOD AND MATERIALS: This study was approved by the institutional review board. One hundred and four HCC masses in 104 patients who had undergone EOB-MRI and liver surgery within one month after EOB-MRI were evaluated. Two radiologists independently recorded the presence of a peritumoral hypointensity on hepatobiliary phase. Interobserver agreement was assessed, and consensus records were used. Tumor size was measured. Chi-square test and independent t-tests were used for univariate analysis. Multiple logistic regression was performed to determine factors for predicting microvascular invasion. Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of peritumoral hypointensity were calculated.RESULTS: Sixty HCCs had microvascular invasion and 44 did not. Interobserver agreement in determining peritumoral hypointensity was excellent (κ = 0.83). By univariate analysis, peritumoral hypointensity and tumor size were significant for predicting microvascular invasion of HCC. On multiple logistic regression analysis, only peritumoral hypointensity was significant in predicting microvascular invasion of HCC (p=0.013). The sensitivity, specificity, PPV, and NPV of peritumoral hypointensity were 38.3%, 93.2%, 88.5%, and 52.6%.CONCLUSION: Peritumoral hypointensity on the hepatobiliary phase of EOB-MRI is not sensitive but has high specificity for predicting microvascular invasion of HCC.
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1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 3. Dissertation
Yonsei Authors
Kim, Kyung Ah(김경아)
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